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September 21, 2010

A new study has found that button batteries, also called disc batteries, lodged in the esophagus of children can do extensive damage within hours, worrying study authors because in an earlier study 22% of physicians said they would not remove such batteries even if lodged in the esophagus.

The study entitled A Review of Esophageal Disc Battery Ingestions and a Protocol for Management appears in the September 2010 issue of the Archives of Otolaryngology – Head & Neck Surgery.

As small consumer electronic devices, such as watches and hearing aids powered by button batteries become more prevalent in our lives, so do incidences of people ingesting the tiny batteries. According to the National Capital Poison Center, people of all ages swallow more than 3,500 button batteries every year in the United States. While most of these button batteries pass through the digestive system, those that hang up in the esophagus or elsewhere in the body can cause extensive damage.

In the study, researchers followed ten pediatric patients who ingested a button battery that lodged in the esophagus and required endoscopic retrieval. Seven of the children had severe esophageal damage. Two children suffered serious damage even though a physician removed the battery within three hours of ingestion.

"A disc battery is an increasingly common foreign body ingested by children," said Stanley J. Kimball, DO, lead researcher from Mount Carmel Health System in Columbus, OH. "There is significant morbidity when the battery is lodged in the esophagus. The physiologic damage is caused by leaking alkaline contents causing a liquefactive necrosis, electrical discharge leading to low-voltage burns, and pressure necrosis."

However, an article in the Los Angeles Times said that study researchers described another study in which a third of physicians said they were unconcerned about swallowed batteries. "Twenty-two percent would not remove even if they were lodged in the esophagus," researchers wrote.

Button batteries can also cause permanent injury if placed in the ear or nose.

Last week, popular Chuck E. Cheese’s Restaurant recalled more than one million children’s toys because the toy’s button batteries posed an ingestion hazard to children. There was one report of a child swallowing a battery and another inserted a battery into his nostril.

The National Capital Poison Center recommends you take these actions if you or someone you know swallows a button battery:

  1. Immediately call the 24-hour National Battery Ingestion Hotline at 202-625-3333 (call collect if necessary), or call your poison center at 1-800-222-1222.
  2. If readily available, provide the battery identification number, found on the package or from a matching battery.
  3. In most cases, an x-ray must be obtained right away to be sure that the battery has gone through the esophagus into the stomach. (If the battery remains in the esophagus, it must be removed immediately. Most batteries move on to the stomach and can be allowed to pass by themselves.) Based on the age of the patient and size of the battery, the National Battery Ingestion Hotline specialists can help you determine if an immediate x-ray is required.
  4. Don’t induce vomiting. Don’t eat or drink until the x-ray shows the battery is beyond the esophagus.
  5. Watch for fever, abdominal pain, vomiting or blood in the stools. Report these symptoms immediately.
  6. Check the stools until the battery has passed.
  7. Your physician or the emergency room may call the National Button Battery Ingestion Hotline/National Capital Poison Center collect at 202-625-3333 for consultation about button batteries. Expert advice is available 24 hours a day, 7 days a week.

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